I was diagnosed with Lyme disease approximately two years ago, and I have been on antibiotics ever since. I have not had any improvement either for the better or for the worse. As you might guess, I am having serious doubts that I really do have Lyme.
Because of this, i've decided to search for information on the legitimacy of the Western Blot results which my doctor used to diagnose me. The CDC standards to diagnose Lyme are rather strict, and I believe there must be a reason for that. If all of the bands were only specific to Lyme disease, there would be no need to require multiple bands to be reactive to arrive at a confident diagnosis. My own Western Blot did not yield many bands at all, and did not even come close to making CDC criteria, but my Dr. seems to think I do have it.
As far as I understand the Western Blot, it measures the presence of antibodies in a patient's blood to particular Lyme spirochete proteins represented by their individual weights in kDa. The question I have is if other bacteria besides Lyme, both native and foreign, can cause the body to produce these same antibodies and cause these same bands to be reactive on the Western Blot.
If anyone knows of a reference sheet that they could direct me to which describes exactly what each of these bands represents and *most importantly*: other known bacteria that would cause them to be reactive on the Western Blot, I would greatly appreciate it! I have searched for this information for a long time to no avail. It would be a great help in determining what might be the real cause of my illness, or at least in determining the chance that it might not be Lyme.
Thank you.
[This message has been edited by JamesT (edited 03 December 2004).]
posted
Hi James, also search the net for essays by Sam Donta. He makes some statements on some bands, but does not offer a list or so. If I remember right, he finds p39 to be unique for lyme. Wether he's right I cannot tell, but he is supposed to be an LLMD and seems quite specialised on lyme. The essays you will find also suggest effective abx protocols. What antibiotics do you take? Total nonresponse to different specific regimens could of course indicate that you do not have lyme but its hard to tell. But what are your symptoms and what alternative diagnoses could be made? Have you been checked for coinfections like babesia or ehrlichia? If you have any of these this could also be the cause you dont get better from lyme treatment. Take care, Petra
Posts: 56 | From Bonn, NRW, Germany | Registered: Oct 2003
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posted
Here's my key to Western Blot bands, compiled from several sources:
Borrelia burgdorferi bands mentioned in medical literature (MEDLINE): Note: Bands preceded with an asterisk are the 11 Western blot bands for the ASTPHLD, CDC, FDA, NIH, CSTE, NCCLS 1994 conference recommendation ("CDC recommendation") for the serologic diagnosis of Lyme disease - see 1995 CDC MMWR link below.
5-kDa 7.5-kDa 11-kDa 13-kDa surface protein - sensu stricto, afzelii (Europe) 14-kDa internal flagellin fragment [specific for Bb] 15 kDa polypeptide [also for syphilis] 16-kDa 17-kDa Osp 17 [B. afzelii] *18-kDa p18 flagellin fragment 19-kDa immunogenic integral membrane lipoproteins cross-reactive with other spirochetes/bacteria Characterization of antigenic determinants of Bb shared by other bacteria. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1372635&form=6&db=m&Dopt=b 19-kDa decorin-binding protein 20-kDa decorin-binding protein 20.7-kDa *21-kDa OspC [specific for Bb] 22-kDa [specific for Bb or cross-reactive depending on what one reads] immunogenic integral membrane lipoproteins [cross-reactive with other spirochetes/bacteria] Characterization of antigenic determinants of Bb shared by other bacteria. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1372635&form=6&db=m&Dopt=b 22-kDa OspC [specific for Bb] 22-25kDa OspC 23-kDa OspC *24-kDa OspC 25-kDa OspC [specific for Bb] 26-kDa 25-kDa 27-kDa Osp, Heat shock protein (Europe burgdorferi strain B29, but not American strain B31) *28-kDa OspD, Oms28 [specific for Bb] 29-kDa 30-32-kDa OspA *30-kDa OspA substrate binding protein 31-kDa OspA [specific for Bb] 32-kDa OspA 33-kDa outer membrane 34-kDa OspB [specific for Bb] 34-36-kDa OspB 35-kDa OspB [specific for Bb] 35.5-kDa 36-37-kDa 37-kDa P37, flaA gene product, [specific for Bb] 38.0-kDa *39-kDa BmpA [specific for Bb] 40-kDa *41-kDa Flagellate 42-kDa 43-kDa 44-kDa *45-kDa [appeared in IgM in control group in 1998 study done in Poland] MEDLINE - 9972057 - "...whereas in control group only antibodies against 45 kDa and 58 kDa were present." http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9972057&form=6&db=m&Dopt=b [appears for HGE] MEDLINE - 9620365 - "...confirmed the importance of the 42- to 45-kDa antigens as early, persistent, and specific markers of HGE infection." http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9620365&form=6&db=m&Dopt=b 46-kDa 47-kDa P47 fibronectin-binding protein [specific for Bb] 48-kDa 49-kDa 50-kDa [specific for Bb] 51 kDa MgtE 52-kDa Fn-BA 54-kDa [other Borrelia] 55-kDa 56-kDa 57-kDa PBP *58-kDa (not GroEL) 59-kDa [a genetically engineeried fragment of the 83-kDa protein] 60-kDa Heat shock protein [all Borrelia] 62-kDa Hsp60 Heat shock protein 63.7-kDa 64-kDa (P64) [cross-reacts to human axonal proteins] 65-kDa *66-kDa P66 Oms66 Hsp outer/integral membrane protein 67-kDa 68-kDa 70-kDa Hsp 71-kDa 72-kDa Hsp [cross-reactive with other spirochetes] [cross-reactive with other spirochetes/bacteria] Characterization of antigenic determinants of Bb shared by other bacteria. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1372635&form=6&db=m&Dopt=b 73-kDa 75-kDa 77-kDa a genetically engineered recombinant hybred Use of a hybrid protein consisting of the variable region of the Borrelia burgdorferi flagellin and part of the 83-kDa protein as antigen for serodiagnosis of Lyme disease. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8027303&form=6&db=m&Dopt=b 78-kDa OspA 79.8-kDa 80-kDa 83-kDa p83 high molecular mass protein [specific for Bb] 84-kDa [B. garinii] mostly Europe 88-kDa 92-kDa *93-kDa an immunodominant protoplasmic cylinder antigen, associated with the flagellum [specific for Bb] 94-kDa PBP [specific for Bb] 95-kDa 97-kDa associated with flagella 100-kDa P100 110-kDa 200-kDa a fusion protein, a hybrid protein
From what I've seen, 41kDA is pretty common, and there can be cross reactivity with a common bacteria in the mouth, but some of your bands can only come from exposure to Bb. Not all bands are created equal!
KrisKraft
Posts: 245 | From Palo Alto, CA USA | Registered: Jul 2003
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posted
Thank you very much for the responses, they were very helpful!
I decided to pull out my Western Blot and compare the results to the information posted.
This is what my WB looked like, with comments from the reference sheet added at the end. I skipped the 'negative' bands in order to save space.
IgG: 34 kDa: +/- equivocal - OspB [specific for BB] 41 kDa: ++ medium - Flagellate 58 kDa: + low - not GroEL 66 kDa: +/- equivocal - P66 Oms66 Hsp outer/integral membrane protein
IgM: 41 kDa: +/- equivocal - Flagellate
The 34kDa band is listed as specific for BB, yet it was equivocal +/-. I'm unsure what to make of this. The 41kDa band was the highest concentrate from the test, but is it truly specific to BB? Listed as Flagellate (the tail?). I know a large variety of bacteria have the 'tail' as a means of propelling itself. The 58kDa band was also listed as showing up, but i'm not sure what the description of 'not GroEL' means. Same with 66kDa band, but this was the only band on the WB test which showed which my doctor did not put a star by, so i'm guessing it is not very conclusive.
At the moment, seeing as there were apparently no lyme specific bands other than the 34kDa (which was equivocal) in my WB, i'm guessing the chance of me having Lyme, taking into account the thorough antibiotic regimen I have already been treated with, is looking slim.
In response to another post, I am currently on no antibiotics. I am giving serious thought to continuing to pursue this treatment at the moment. I have been on a large variety of them though, some of which were Flagyl, Zithromax, Doxycycline, Rifampin, and the rest of the exact names escape me at the moment. I didn't have side effects to any of them, neither adverse or beneficial. I don't believe I was tested for coinfections, (it was so long ago when the tests were done), but if I recall correctly, the reason the doctor provided for not testing for them was that the antibiotics he prescribed would take care of the infection regardless of which it was. My doctor wants me to try intraveinous antibiotics with a pic line as the next attempt at treatment, starting all over again with the same antibiotics I had already tried oral. I feel as if I am going around in circles.
I'm going to attempt to find the essays mentioned above and do some looking around to hopefully get a better idea of what these particular bands and descriptions, but I just thought I would post this in the mean time if anyone had any comments on it.
Thanks.
[This message has been edited by JamesT (edited 07 December 2004).]
Print it out. Yes, it's long...about 20 pages. A mere "sampling" of literally hundreds of MS word files that I have collected over 3 years when abx. failed my sister and I set out to try to understand WHY. (She was given steroids initially and the disease really got a foothold.)
Posts: 9424 | From Sunshine State | Registered: Mar 2001
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REASONS WHY A SERONEGATIVE TEST RESULT MIGHT OCCUR
1. Recent infection before immune response 2. Antibodies are in immune complexes 3. Spirochete encapsulated by host tissue (i.e. lymphocytic cell walls) 4. Spirochetes are deep in host tissue 5. Only blebs in body fluid; no whole organisms needed for PCR 6. No spirochetes in body fluid on day of test 7. Genetic heterogeneity (300 strains in U.S.) 8. Antigenic variability 9. Surface antigens change with temperature 10.Utilization of host protease instead of microbial protease 11.Spirochete in dormancy phase 12.Recent antibiotic treatment 13.Recent anti-inflammatory treatment 14.Concomitant infection with babesia may cause immunosuppression 15.Other causes of immunosuppression 16.Lab with poor technical capability for Lyme disease 17.Lab tests not standardized for late stage disease 18.Lab tests labeled "for investigational use only" 19.CDC criteria is epidemiological, not a diagnostic criteria http://www.drcharlescrist.com/testing.htm
In the above link, dr c explains that an "equivocal" is just as good as a "positive" in his book because it means they see SOMETHING. If it's there, it's there.
Band 34 is a classic hallmark borreliosis antibody You can't ignore that.
Also band 66...even though it's heat shock protein, it's listed as the second most common borrelia antibody.
Hope this helps. Please read [or re-read] Dr C's western blot explanation.
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